Sick or Psych?

# Sick or Psych? Many of us carry questions about where the line goes between being sick and simply going through a rough time. When faced with mental disorders and life’s natural emotional swings, there arises a need to understand: When does it concern a diagnosis, and when is it about the human experience? These are questions that we all, to varying degrees, grapple with throughout life. This is particularly true in relation to the phenomenon of bipolar disorder. ## Riding Life’s Highs and Lows Bipolarity is, for many, a concept shrouded in mystery or distance. The diagnosis is often associated with extreme highs and lows, and may seem like something few truly understand. But fundamentally, bipolar disorder, like other mental health conditions, is about variations and dynamics in mood—emotions that shift, sometimes intensely, and lives lived moving between energy and emptiness, joy and sorrow. Conversations with people diagnosed with bipolar disorder illustrate this diversity. For some, the manic periods bring euphoric energy, a feeling of boundless connection with the world, an almost spiritual contact with nature and people. Others describe themselves as trapped in an exhausting inner chaos; boundaries between themselves and their surroundings blur, and relationships are challenged when impulses and intensity reach unhealthy levels. Mania has many faces: It can be creative, full of initiative and sociable, but also exhausting, disruptive, and bring consequences for finances, work, and social ties. Many experience—as we see in accounts from writers and artists throughout history—that manic phases offer access to new insights and experiences, but also loss. As a psychologist, I see how these intense fluctuations are not just symptoms, but can be understood as attempts to handle experiences, losses, or wounds from earlier in life. ## The Importance of Upbringing—Vulnerability and Coping Several describe that manic periods can be a way to compensate for deeper wounds from childhood and upbringing. In periods of pain and a lack of recognition as a child, there may later arise a need to be seen, loved, and validated. When such needs aren't met by caring adults or develop into healthy inner dialogues, the feelings can accumulate. In adulthood, this can explode—sometimes in the form of the intense emotional outbursts characteristic of bipolar mania. Mental disorders are therefore often more than just biological predispositions. They are subtle interactions between genetics, personality, experience, and environment. Diagnoses like bipolarity only partially capture this complexity. For some, the energy dominates; for others, it’s the loss and grief. The American psychiatrist Kay Redfield Jamison, who herself has bipolar disorder, writes in the book "An Unquiet Mind" about how creativity and passion live side by side with deep darkness. Psychological theory, particularly psychodynamic tradition, assigns significant importance to such childhood experiences, emphasizing how old emotions can leave deep traces and trigger feelings in adulthood that can feel overwhelming. ## The Double-Edged Nature of Diagnosis—Relief and Burden It’s easy to think that a diagnosis provides a solid and concrete explanation of the situation. That is rarely the case. Mental health diagnoses—in contrast to many physical illnesses—often lack clear biological markers. As is aptly said: There is no blood test for bipolar disorder. The diagnosis is made based on symptom patterns, that is, how experiences, feelings, and behavior manifest over time. This leaves room for great variation. Many experience the diagnosis as a relief. Finally, they have language for what once was incomprehensible and shameful. It gives a legitimate reason to seek help and accommodations. At the same time, a burden follows: Being “a bipolar” can feel stigmatizing and confining, as if one's identity is reduced to a medical label. Psychology professor Edwin Schneidman has described how the language we use about mental distress shapes the way we understand ourselves and our life stories. ## Depression—Loss of Meaning or Overwhelming Emotion Where mania can lift and open doors to unknown landscapes, depression is often the opposite—a state where meaning disappears, where one withdraws and loses touch with both oneself and others. For some, depression means penetrating sadness and crying fits; for others, an almost total lack of feelings and energy. What once brought joy now has no flavor. Depression is certainly not just about sadness. It can also involve a sense of emptiness, erasure of identity and dignity. For some, it’s described almost as an ego-death, where all that was inflated or grandiose collapses into a more humble and often vulnerable version of the self. Others lose belief in themselves, their worth, and their future. Psychiatrist Andrew Solomon writes in the book "The Noonday Demon" about how depression can be experienced both as a loss of joy and as a painful encounter with parts of ourselves and our lives we'd rather avoid. Another perspective, from existential psychology, understands such states as a confrontation with life’s implacable questions about meaning, loneliness, and freedom—challenges none of us fully escape. ## Society and the Influence of Language How we understand mental health is largely shaped by society’s expectations and the language available to us. In a culture marked by achievement, success, and self-management, feelings like shame, grief, or despair are often pushed to the margins. Many learn early to hide or suppress what hurts, for fear of appearing weak or different. When life’s natural fluctuations are overdiagnosed, we risk viewing ordinary reactions as illness; conversely, when real distress is trivialized or not acknowledged, we don’t get the help we need. Psychologist Viktor Frankl, in his book "Man’s Search for Meaning," emphasizes the importance of finding meaning, even in pain. The way we frame and meet our own feelings—whether with understanding or condemnation—directly affects the outcome. ## Meeting Your Own Feelings—Holding the Difficult In working with mental health, it becomes clear that the key to improvement often lies in acceptance and self-compassion. Many discover that allowing themselves to feel what’s difficult, without immediately judging or fleeing, can be liberating. As the American psychologist Kristin Neff writes about self-compassion: Meeting yourself with warmth and understanding, instead of criticism, can reduce shame and build resilience. It is in the recognition that both ups and downs are part of being human that freedom lies. Acknowledging that strong feelings, whether rooted in the past or arising suddenly, do not make us crazy or defective, but rather express a life lived with openness and vulnerability. Pia Beate Pedersen, who has written about her own experiences with bipolarity, puts it this way: “If I accept this in myself, there is a potential freedom in that.” ## A Gentler Look at Ourselves—the Path Forward Many of the myths we encounter about mental struggles revolve around fear and lack of understanding. To think that mental health challenges only happen to the weakest, or that it's possible to shield oneself entirely from hard times, are unhelpful simplifications. In reality, life, with all its fluctuations, is the only normal. As a psychologist, I emphasize the importance of integrating our own experiences and feelings into a bigger picture. When we stop fighting ourselves and begin to embrace our full range, we open up for both growth and relief. Diagnoses can be helpful, but they do not tell the whole truth about who we are. Often, they are just one way of understanding our life stories, and there are many more paths—in our personality, our choices, our ties to others. Recognition and openness, in meeting ourselves and others, paves the way for healing. By allowing ourselves to be both strong and vulnerable, we approach the kind of mental balance that lets us meet life as it is. Our psychological responses are often not signs of illness, but just as much testaments to life, growth, and connection with what is meaningful to us. ## Summary—Mental Health in a New Light The question “sick or psych?” is not always possible to answer unequivocally. There are fluid boundaries between having a hard time and having a mental disorder. Mental swings are—to a certain extent—a natural part of being human. When they become too intense or last too long, they can take on the characteristics of illness and benefit from professional help. At the same time, we should be careful not to medicalize everything that is difficult. Increasing research and experience highlight the importance of building understanding, openness, and a more nuanced language around mental health. It’s not just about managing symptoms, but about developing maturity to face life’s complex reality. By exploring our own experiences, seeing connections, and seeking support from spouses, friends, or professionals when needed, we build a psychological resilience that endures. Closely linked to working on self-understanding is the psychological concept of “insight.” Being able to see oneself with a friendly, inquisitive gaze, rather than a judgmental one, lays the foundation for both relief and growth. In this way, we can all find our balance—between being sick and being “psych,” between carrying wounds and finding strength in them. --- **Do you want to dive deeper into this topic?** This is a topic psychologist Sondre Risholm Liverød discusses further in the podcast episode of the same name. You’ll find the episode as part of the exercise materials at [BeBalanced.ai](https://bebalanced.ai).